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背景:已证实白细胞介素18参与了急性脑梗死的发病过程,并与脑卒中发病时间,患者血沉变化及神经功能缺损程度和脑CT 的低密度值成正相关。目的:观察急性脑梗死患者血清白细胞介素18水平随发病时间的变化而发生的动态改变。设计:以患者为观察对象,以健康者为对照组的验证性分析。单位:一所市级医院神经内科。对象:选择2002-11/2004-01茂名市人民医院神经内科的住院急性脑梗死患者46例,男29例,女17例。健康对照组40例均为本院健康体检者,男27例,女13例。均知情同意。方法:所有病例均于发病后第1天,第7天,第14天,第21天4次,健康对照组于体检当天空腹,均抽取外周静脉血2m L,3000r/m in,4℃,离心15m in,取血清。采用酶联免疫吸附法测定白细胞介素18水平。主要观察指标:急性脑梗死患者发病后第1天,第7天,第14天,第21天和健康对照组的血清白细胞介素18水平。结果:纳入分析的46例患者,40例健康对照者血样合格,均进入结果分析。①急性脑梗死患者的血清白细胞介素18水平在发病后的第1天和第7天均明显高于健康对照组犤(178±41)ng/L,(104±34)ng/L,(65±14)ng/L,P均<0.01犦,而发病后的第14天和第21天的白细胞介素18水平则与健康对照组基本一致犤(88±36) ng/L,(72±33)ng/L,(65±14)ng/L,P均>0.05犦。急性脑梗死患者第1天的血清白细胞介素18水平明显高于第7天,第14天,第21天(P <0.05～0.01);第7天的血清白细胞介素18水平高于第21天(P <0.05)。结论:白细胞介素18水平在发生急性脑梗死第1天时明显升高,随发病和治疗时间的延长,其水平逐渐下降。
BACKGROUND: Interleukin-18 has been shown to be involved in the pathogenesis of acute cerebral infarction and is positively correlated with the time of onset of stroke, changes in edema and neurological deficit, and the low density of brain CT. Objective: To observe the dynamic changes of serum interleukin-18 level in patients with acute cerebral infarction with the onset time. Design: The patient as the observation object, the healthy person as the control group confirmatory analysis. Unit: a municipal hospital neurology. PARTICIPANTS: Forty-six inpatients with acute cerebral infarction, male 29 and female 17, were enrolled in the Department of Neurology, Maoming People’s Hospital from November 2002 to January 2004. Forty healthy people were healthy in this hospital, 27 males and 13 females. Informed consent. Methods: All patients were on the first day, the seventh day, the fourteenth day and the 21st day after the onset of symptoms. The healthy control group were fasting on the day of the physical examination, and the peripheral venous blood was drawn at 2m L, 3000r / m in, 4 ℃, Centrifuge 15m in and take serum. Interleukin-18 levels were measured by enzyme-linked immunosorbent assay. MAIN OUTCOME MEASURES: Serum interleukin-18 levels were measured on day 1, day 7, day 14, day 21 and healthy controls after onset of acute cerebral infarction. Results: The blood samples of 46 patients and 40 healthy controls included in the analysis were all included in the result analysis. ① The levels of serum interleukin-18 in patients with acute cerebral infarction were significantly higher than those in healthy controls (178 ± 41 ng / L, (104 ± 34) ng / L, (P <0.01), while the levels of interleukin 18 on the 14th and 21st days after onset were almost the same as those in healthy controls (88 ± 36) ng / L, (72 ± 65) ng / L ± 33) ng / L, (65 ± 14) ng / L, P> 0.05 犦. Serum levels of IL-18 on day 1 in patients with acute cerebral infarction were significantly higher than those on day 7, day 14, and day 21 (P <0.05-0.01); serum interleukin 18 levels on day 7 were higher than those on day 21 Day (P <0.05). Conclusion: The level of interleukin 18 is obviously increased on the first day of acute cerebral infarction. The level of interleukin 18 gradually decreases with the onset of disease and the prolongation of treatment time.